Provider Demographics
NPI:1023430980
Name:DTMB CONSULTANS
Entity type:Organization
Organization Name:DTMB CONSULTANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:BOWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-882-8982
Mailing Address - Street 1:455 NE 5TH AVE
Mailing Address - Street 2:SUITE D115
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5658
Mailing Address - Country:US
Mailing Address - Phone:732-882-8982
Mailing Address - Fax:
Practice Address - Street 1:702 NE 8TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5745
Practice Address - Country:US
Practice Address - Phone:561-274-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility